A design for studying the DSM-IV research criteria of premenstrual dysphoric disorder.

The DSM-IV estimate that 3-5% of women have premenstrual dysphoric disorder (PMDD) is based on studies that: used non-representative samples, did not consider all research criteria, or were retrospective. In the present study, prospective data from a multiethnic sample of women were analyzed to develop an effective method of considering all DSM-IV research criteria for PMDD. One-hundred and seventeen subjects between the ages of 13 and 55 years who were neither pregnant nor menopausal were recruited from outpatient clinics at a teaching hospital for a study of changes in women's health through time. Daily urine samples were taken for two menstrual cycles, analyzed to establish phase of cycle, and correlated with daily symptom ratings. Subjects were assessed for psychiatric disorders. Four methods of symptom analysis were used. Prevalence rates ranging from 1.0% to 7.1% were determined that differed according to the method of measuring the symptom change. The group of women with PMDD did not differ from the sample as a whole on variables including age, parity and birth control pill use. When all criteria were considered as they appear in DSM-IV, prevalence estimates of the present study did not differ markedly from those in DSM-IV.